Sunday, January 06, 2013


The following statement was released by Beyond AIDS on World AIDS Day, December 1, 2012:

The world’s HIV/AIDS epidemic could soon be controlled, if every community were to adopt the types of programs and policies now in place for New York City. That is the conclusion of Beyond AIDS, a national organization dedicated to reversing that epidemic through sound public health policy. Dr. Monica Sweeney, Assistant Commissioner at the New York City Health Department, gave a presentation about the New York City program at the organization’s annual meeting (and at its expense), in Southern California on November 17.
Dr. Monica Sweeney, Asst. Commissioner of Health, NYC
 “We are very impressed with what New York City is doing,” said Dr. Ronald Hattis of Redlands, California, President of Beyond AIDS. “Every new HIV infection represents a failure to prevent transmission from an existing case,” he continued. “The New York program gets more patients into treatment at an early stage, which suppresses their HIV and makes them much less likely to pass the virus on. If almost all infected persons could be effectively treated before they infect anyone, combined with regular condom use and safer sexual and drug behavior, the epidemic could be brought to an eventual end.”

In late 2011, results from multinational clinical trial with the code name HPTN 052 were announced, which showed that treatment that brought the virus down to an undetectable level in the blood could reduce transmission to sexual partners by 96%. New York City implemented this concept before it had been translated into policy elsewhere.

On December 1, 2011, Mayor Michael Bloomberg and Health Commissioner Thomas Farley released recommendations that healthcare providers offer antiviral drugs to any person living with HIV, regardless of the person’s CD4 count. At that time, the national recommendation was to delay treatment until that count (of a type of white blood cell critical to the immune system) dropped below 500, which could take years. That move, and similar action by San Francisco’s Department of Public Health, helped lead to similar recommendations for the entire nation, almost four months later. There has been little nationwide promotion or implementation of the strategy so far. As a result of New York’s head start, however, already 39% of persons infected in the city have suppressed levels of virus and are unlikely to infected anyone else, compared with 25% nationally.

Other things that impressed Beyond AIDS include the NYC condom availability program, which distributed 36 million male condoms in 2011 at more than 3,900 venues citywide. In addition, New York City distributed 1.3 million female condoms, which are not widely used in most other locations. There is even a NYC condom finder application for mobile phones. The city also has a successful marketing campaign for HIV/AIDS awareness, and a widespread HIV testing program.

“The combination of better control of infection at the source, that is, helping the infected person not to transmit, and also prevention programs including testing and condom availability aimed at entire populations at risk, makes New York City’s program the closest we have found to what we consider the optimal strategy,” said Hattis. “What we want is for every city and state, and every nation, to replicate the sort of things that New York City is doing to control this disease.”

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